Melanoma skin cancer can be fatal unless caught early, but most skin lesions are harmless. Dermoscopy with training can help with diagnosis. This blog is not a substitute for a medical opinion-if you are worried about a changing or funny looking mole or spot, get it checked by a doctor with suitable skills.

listen to your wife!

a mole on a young man's back, his wife said it had appeared and changed over the previous year. Wise man, he listened to her,

dermoscopic image of changing mole

This very odd looking naevus was noticed on a 30 year old man’s back by his wife, who was sure it wasn’t there, or at least not like that, a year ago. A loved one’s concern about a changing mole should always be heeded. In the ABCDEF mnemonic, E is for Evolution, meaning change over time. I also say it’s for Erythema (redness) as melanoma stimulates the immune system and causes redness. Red, black and brown is an evil colour combination in a mole.

On plain view, the lesion is strikingly asymmetrical. The patient had about 50 moles on his trunk, average size 3-5 mm. All but this one were round or oval with even medium brown with no atypia This mole stood out dramatically from all the other moles thus was an ‘ugly duckling’. It fails A (Asymmetry) C (mixed Colour) D (Diameter over 6mm) and F for Funny (funny peculiar, not funny hilarious.)

Dermoscopy shows irregularly sized and asymmetrically distributed globules over a medium brown cobblestone appearance to this part of the mole, plus an amorphous blue/black blotch with a suggestion of a blue/white veil. There was no option but to excise urgently for histology. It was a thin, and so good outlook melanoma.

Men, if you are fortunate enough to have a wife, LISTEN TO HER. Especially when she says ‘I don’t like the look of that mole on your back, please get it checked.’